Volume 10, Issue 2, May 2008
Eszter Varga, Tamás Tényi, Sándor Fekete, Róbert Herold
Patients with schizophrenia have difficulties in representing of the mental states of others. The impairment can be detected not only in the acut phase but also in remission. Patients in remission are able to pass first- and secound order „theory of mind” tasks, but they have difficulties to understand more complex situations (such as irony). In our study faux pas tasks were used to assess mentalization deficits among patients with schizophrenia. Seventeen patients with schizophrenia and seventeen matched controll inviduals were evaluated. A computerized programme was used to present the tasks, to store the answers and the time the participants used to read the questions and answer. The patients with schizophrenia performed a sinificant impairment in the faux pas tasks. Beside, an improving tendency were found in the patient’s answers, that may mean a capacity to „learn” in the dimension of mentalization.
KEYWORDS: mentalization, faux pas, schizophrenia, theory of mind
László Péter, Péter Döme, Zoltán Rihmer, Gábor Kovács, Gábor Faludi
Depression is a common comorbid condition in patients with cardiovascular diseases (CVD) and a well-known risk factor for the development of CVD and CV mortality too. Depression and CVD are prevalent public health problems in the Western world. The background mechanisms underlying the relationship between depression and CVD are not well clarified. In this article, we review the recent knowledge regarding epidemiological data and possible etiological mechanisms (ie. higher prevalence of smoking, hypertension, metabolic syndrome, obesity in depression or the platelet hyperactivity theory and the endothelial progenitor cell theory) in point of the comorbidity of CVD and mood disorders.
KEYWORDS: depression, mood-disorders, cardiovascular morbidity and mortality, comorbidity
X. Gonda, J. Lazary, T. Telek, D. Pap, Z. Katai, Gy. Bagdy
OBJECTIVE: The cyclic variation of physical and psychological phenomena has been accepted as a natural consequence of the cyclicity of the human female reproductive function. The exact nature of these changes, however, has not been fully understood. The aim of our study was to investigate the fluctuation of psychological and physical symptoms throughout the female reproductive cycle in healthy, non-PMDD women.
METHOD: 63 psychiatrically healthy, non-PMDD women with normal regular menstrual cycles and not using hormonal contraceptive methods participated in the study. Participants completed the PRISM calendar every night for three consecutive cycles and on three predefined days of the first cycle they completed several other psychometric measures (SCL-51, STAI, ZSDS, EAT and Mind and Body Cathexis Scale). Based on an at least 66% increase in physical symptoms from the late follicular to the late luteal phase on the PRISM, subjects were assigned to LPPS (luteal phase physical symptoms) and nonLPPS (no luteal phase physical symptoms) groups. Average of psychometric scores obtained at the three predefined days were compared between the two groups.
RESULTS: There was a significant difference between the two groups only in case of the interpersonal sensitivity subscale of the SCL-51.
CONCLUSION: Our results indicate that the appearance of severe physical symptoms in the late luteal phase of the female reproductive cycle is not accompanied by a worsening of psychological symptoms. The appearance of enhanced psychological symptomatology attributed to the luteal phase of the female reproductive cycle thus seems to be independent of the appearance of severe physical symptoms.
Keywords: reproductive cycle, depression, anxiety, premenstrual syndrome
László Köles, Zoltán Gerevich, Holger Kittner, Ute Krügel, Heike Franke, Péter Illés
The ventral tegmental area (VTA), the prefrontal cortex and the nucleus accumbens (NAc) are key elements of the mesolimbic dopaminergic system. Dopaminergic neurotransmission in the NAc is essential in the regulation of motor activity and reward. Extracellular ATP by activating P2 receptors may function as a neurotransmitter or a neuromodulator. We showed that P2 receptors are expressed both in the NAc and VTA, and their activation (probably of the P2Y1 subtype) results in increased dopamine release. It leads to complex neurophysiologic and behavioral changes. We observed activation of the EEG: an elevation of the absolute EEG power and the power in the alpha-frequency band as well as decrease in the delta-frequency band. Behavioral studies demonstrated that activation of P2 receptors elicited more consistent and stronger goal-directed locomotor activity in response to the stimulus of a novel environment. P2Y receptors were also involved in regulation of feeding, their inhibition decreased the amount and the duration of feeding. On the other hand, in various behavioral functions, P2 receptor-mediated glutamate release or the activation of the adenosine receptors counterbalanced the actions mediated by ATP-induced dopamine release. We also showed that enhancement of the P2Y1 receptor expression may be involved in adaptive changes of the mesolimbic system such as behavioral sensitization to repeated amphetamine administration. In summary, the mesolimbic dopaminergic system is modulated via P2Y purinergic receptors, and it may lead to complex behavioral pharmacological changes.
Keywords: neuromodulation, dopaminergic, purinergic, mesolimbic, behavior
We have limited resources available for the treatment and prevention of violent behavior. The usefulness of the most commonly used medications, namely the selective serotonin-reuptake inhibitor [SSRI] agents for the above purpose is a debated issue in the psychiatric literature. The aim of this case report is to add an ethnopharmacological perspective to the management of human aggression. Particularly, attention is called to the potential prosocial effect of the Amazonian beverage, ayahuasca–a decoctum, which has been used traditionally for multiple medico-religious purposes by numerous indigenous groups of the Upper Amazon–and has been found to be useful in crisis intervention, achieving redemption, as well as eliciting cathartic feelings with moral content.
Keywords: ayahuasca, SSRI, agressiveness
INTRODUCTION: There are altogether four reported cases in the literature about psychotic episodes associated with sibutramine, which has been registered as an appetite suppressant for 10 years. OBJECTIVE:Authors review the case of a patient who, after being on sibutramine for three weeks, passed gradually into a psychotic state. CASE SUMMARY: A 39-year-old white woman started to take sibutramine to lose weight at a dosage of 10 mg/day. After taking the pill for two weeks her behavior changed basically, she neglected her tasks and irrealistic thoughts appeared in her mind. Later, she recalled these weeks as if they had been a dream. In two weeks time after spontaneous abrupt of sibutramine intake symptoms disappeared without any treatment. The examination did not reveal organic disturbances or psychiatric illnesses. DISCUSSION: The result of the psychological examination rendered it probable, that the multitude of severe difficulties the patient had experienced in her life before she developed a pathological condition had weakened her psychic defense mechanism, making her vulnerable to the drug’s psychosis-inducing properties. The correlation between the symptoms and sibutramine intake according to the Naranjo ADR scale is “probable”. CONCLUSION: On the basis of this case, authors suggest that those persons exposed to increased stress or being vulnerable to psychosis in any other way should take sibutramine with extra caution and under close supervision only.
KEYWORDS: sibutramine, appetite suppressant, psychosis, stress, vulnerability